By Janice Petrella Lynch, RN, MSN
Babies, children and adolescents of divorced parents exhibit physical symptoms that nurses and other healthcare colleagues may not realize are directly related to family stress and disruption, according to Jolene Oppawsky, RN, PhD, LPC, ACS, DAPA, faculty, University of Phoenix,
Ive seen babies display increased signs of irritability and crying. Ive seen older children complain of stomach aches and headaches, and we cant put our finger on the etiology, said Oppawsky. Rather than identifying the real cause, the signs and symptoms are confused with other physical ailments and illnesses.
As a clinician, Oppawsky has counseled patients and families in crisis, and as an educator, she has supervised undergraduate and graduate students in mental health clinics and other settings.
Well into her career, Oppawsky decided to pursue her doctorate and focused her doctoral research on the effects of parental divorce from the perspectives of children and adolescents.
In her practice and research, Oppawsky identified the critical role nurses play in the assessment process and in the implementation of ameliorative measures. As nurses gather the health history, they learn more about the patient and family and can inquire in a nonthreatening manner about any specific changes the child has experienced over the past year, whether it be a move to a new home or school, a death in the family, sudden illness in the family or divorce.
In the know
We are often the first professionals who see children of divorced parents, and we need to identify the etiology and understand the different responses we see, depending on the chronological ages and developmental levels, Oppawsky said.
Oppawsky found in her practice that while some reactions are those seen in a crisis situation, such as fear, anger and grief, other young children display obstinate behavior, masturbation, aggression, tics, eneuresis and night terrors. Older children show signs of emotional distancing or changes in their parental relationship, and psychopathologic responses include depressive signs and symptoms, regression and failure to cope, said Oppawsky.
Raising the awareness of other healthcare colleagues is essential, according to Oppawsky, when intervening and facilitating referrals and follow-up. Nurses need to learn about appropriate and available community agencies and resource centers that help children and parents deal with the problems of divorce, she said.
Advice to help RNs help patients
Oppawsky cautions nurses to be attentive whenever they work with babies, children and adolescents and offers these words of advice:
– Understand age is not a safeguard against the negative effects of divorce.
– Know normal developmental milestones so that abnormal reactions during lifespan development are identified and a plan of care can be formulated around symptoms, such as temper tantrums, loss of appetite, overeating, sleeplessness, anxiety or depression.
– Keep current with the latest professional literature on the issue, both in nursing and in other related fields, and attend workshops and seminars.
– Conduct nursing research so that the level of awareness is raised and there is a greater understanding of individual and family needs.
Over the years, we raised the professions awareness about children and sexual abuse, and we need to do the same thing about the effects of divorce on children, said Oppawsky.
As a faculty member, I have the opportunity to highlight the importance of making accurate assessments, which are practiced in real-life nursing settings, she said. Once an accurate assessment is made, nurses can assist in ameliorating symptoms, which will facilitate in the childs adjustment.
In addition to her other credentials, Oppawsky is a licensed clinical psychologist and a psychotherapist in Germany.
Janice Petrella Lynch, RN, MSN, is nurse editor/nurse executive.